Objective To systematically review and meta-analyze COVID-19 vaccine hesitancy among individuals with epilepsy. Methods Following PRISMA 2020 guidelines, we searched Cochrane CENTRAL, MEDLINE, EMBASE, CINAHL, LILACS, PsycINFO databases, and grey literature through February 6, 2026. We included studies addressing COVID-19 vaccination hesitancy in adults with epilepsy, with no date or language restrictions. Two reviewers independently screened articles, extracted data, and assessed quality using the Newcastle-Ottawa Scale (NOS). Meta-analyses were conducted using random-effects models, with heterogeneity assessed using I² statistics. The certainty of evidence was evaluated using the GRADE criteria. Results Fourteen studies comprising 4,230 participants were included. Overall vaccination willingness was 51.7% (95% CI: 36.6-68.8%, I²=98%). Among unvaccinated individuals, 44.2% (95% CI: 26.6-61.8%, I²=95%) expressed willingness to be vaccinated. Well-controlled epilepsy was associated with higher vaccination rates (OR 1.91, 95% CI: 1.49-2.46, I²=0%). Conversely, frequent seizures (daily/weekly) were associated with lower vaccination likelihood (OR 0.52, 95% CI: 0.35-0.76, I²=0%). The primary reasons for vaccine hesitancy were fear of seizure worsening (23.8-88.5% across studies) and concerns about side effects (13.0-53.0%). Methodological quality was generally poor, with only one study rated as "satisfactory" using NOS criteria. GRADE assessment indicated very low certainty of evidence due to serious risk of bias, inconsistency, and imprecision. Conclusions COVID-19 vaccine hesitancy remains present in people with epilepsy, primarily driven by concerns about seizure exacerbation. Individuals with well-controlled epilepsy show higher vaccination acceptance. Healthcare providers should address specific concerns about seizure control while emphasizing vaccine safety data. High-quality prospective studies using validated instruments are recommended.

IMPORTANCE:Currently, many postmenopausal women experience symptoms related to the cessation of hormone production, and hormone therapy is the most commonly used treatment to alleviate these symptoms. However, it is contraindicated in several situations, which highlights the importance of alternative therapies such as royal jelly (RJ), particularly given the limited number of studies demonstrating its effectiveness. OBJECTIVE:To evaluate the effects of RJ supplementation on postmenopausal symptoms in women. EVIDENCE REVIEW:We developed a search strategy using "royal jelly" and "menopause" with their synonyms. Terms were combined using Boolean operators (OR for synonyms, AND between concepts). We searched MEDLINE (PubMed), LILACS (BVS), Embase (Elsevier), and Cochrane Library through May 2025. Studies were included if they evaluated interventions for postmenopausal symptoms, with outcomes including genitourinary symptoms and quality of life measures. FINDINGS:A total of 281 studies were identified; 262 were excluded. Of the remaining 19, 14 were selected for full-text reading, and 6 studies involving 471 postmenopausal women were included in the final analysis. The studies were published between 2011 and 2021. RJ supplementation significantly improved postmenopausal symptoms compared with placebo (standardized mean difference=0.73; 95% confidence interval=0.50-0.96; P <0.00001; I2 =0%, two studies, 312 participants, moderate-quality evidence). CONCLUSIONS AND RELEVANCE:RJ supplementation may offer a promising nonhormone option for managing menopausal symptoms and supporting bone and genitourinary health, especially for women who cannot or prefer not to use hormone therapy.

Introduction: Urbanization among Brazilian Indigenous peoples has transformed cultural, dietary, and health patterns, increasing exposure to risk behaviors and chronic diseases. Objective: To describe and analyze health-related behaviors and social determinants among Indigenous people living in an urban community in Campo Grande (MS), Brazil. Methods: Cross-sectional descriptive study with 61 Indigenous participants from Jardim Aeroporto community. A culturally adapted version of the VIGITEL questionnaire assessed sociodemographic, dietary, physical activity, sleep, self-medication, and chronic disease data. Data were analyzed using Stata 17 with frequencies and 95% confidence intervals. Results: Most participants were female (62.3%) and half had completed high school. Hypertension (22.9%), diabetes (13.1%), and abusive alcohol consumption (27.9%) were prevalent. Low regular physical activity (29.5%), meal replacement with snacks (85.2%), and self-medication (23%) were also observed. Conclusion: Findings reveal risk patterns linked to dietary transition and urbanization processes among Indigenous peoples. Intercultural public policies and intersectoral health promotion strategies are needed to address urban Indigenous health disparities.

Among the main consequences of menopause are changes in body weight, lipid and metabolic profiles, as well as an increased risk of cardiovascular disease. This study aimed to analyze the effects of green tea consumption on the metabolic profile of postmenopausal women. This is a systematic review of randomized controlled trials (RCTs) evaluating the effects of green tea compared with placebo in postmenopausal women. The search was conducted in the following electronic databases: MEDLINE via PubMed, EMBASE via Elsevier, the Cochrane Library, LILACS via BVS, and Web of Science, using the terms “Tea,” “Green tea extract,” “Metabolic profile”, “Menopause,” and “Postmenopause” (MeSH descriptors and synonyms). The outcomes listed in the study protocol were: weight, body mass index (BMI), body composition, lipid profile, and blood glucose. Data were collected from seven RCTs that met the selection criteria. The meta-analysis showed that green tea reduced total cholesterol levels in postmenopausal women (mean difference [MD]: −7.03; 95

To systematically evaluate the impact of SSRIs on sexual function in adults with depression compared to placebo through a systematic review and meta-analysis of randomized controlled trials (RCTs). A systematic search using the terms “sexual dysfunction”, “depression” and “antidepressant” was conducted in PubMed/MEDLINE, LILACS, Embase, and the Cochrane Library for RCTs published up to June 2025. No language restrictions were applied. Both dichotomous and continuous outcomes were analyzed with 95

OBJECTIVE:To assess the association between menopausal hormone therapy use and Rheumatoid Arthritis (RA) incidence among postmenopausal women. METHODS:A systematic review and meta-analysis were conducted following PRISMA guidelines. MEDLINE, Embase, and the Cochrane Library were searched up to October 2025 for observational studies evaluating menopausal hormone therapy use and RA risk. Pooled risk ratios (RR) with 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup analyses explored current versus former use and therapy duration. RESULTS:Five studies comprising 22,291,843 person-years of follow-up were included. Overall, menopausal hormone therapy use was associated with a modestly increased RA risk (Rate Ratio 1.15, 95% CI 1.10-1.21, p < 0.001; I² = 0%). Current users had higher risk (Rate Ratio 1.18, 95% CI 1.00-1.37, p = 0.04) compared with former users (Rate Ratio 1.11, 95% CI 0.94-1.32, p = 0.20). Long-term use (≥4 years) conferred greater risk (Rate Ratio 1.19, 95% CI 1.07-1.33, p = 0.002). CONCLUSIONS:Current menopausal hormone therapy use is associated with a modestly higher incidence of rheumatoid arthritis. Although the absolute increase is small, the widespread use highlights the need for individualized risk-benefit assessment, especially in women with autoimmune susceptibility.

BACKGROUND:Systematic Reviews (SRs) rigorously synthesize findings on a theme, but some articles with this design are redundant due to errors and conflicts. Meta-research aims to rigorously analyze research, assessing SRs' methodological quality and result reliability. This study evaluates SRs' overall quality in low- and middle-income countries (LMICs) on chronic non-communicable Diseases (NCDs) and key modifiable risk factors, using assessment tools. METHODS:A search strategy was conducted in the following databases: MEDLINE (via PubMed), Embase, (via Elsevier), Cochrane Library, and Grey Literature for published studies from January 1, 2014 - April 5, 2024. SRs addressing the association between at least one of the four most important modifiable behavioral risk factors (tobacco use, inadequate diet, alcohol consumption, and physical inactivity) and chronic NCDs in populations classified as LMICs according to the 'World Bank list of countries' were included. The selected studies were imported into the EndNote 20 software and analyzed using a form for the extraction of their main data and four tools were chosen to assess each of the most important domains of scientific evidence: Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) for article writing; Template for Intervention Description and Replication (TIDieR) for intervention description; A Measurement Tool for Evaluating Systematic Reviews (AMSTAR-2) for methodological assessment; and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) for certainty of evidence. RESULTS:Nine studies were included in this analysis. The average Overall Score on the PRISMA 2020 checklist was 13.5 for articles published before 2020 and 25.67 for those published after 2020. TIDieR analysis revealed complete correspondence (100%) for item 'Brief Name', while other items, like 'Why' (89%), and 'What', 'Who Provided', and 'How' (78%), were partially met but significantly so. Regarding AMSTAR-2 criteria, only one study fulfilled all critical items, meeting item 7 by providing a detailed list of excluded studies and justifying each exclusion motive. Additionally, among critical items applicable to multiple articles, only item 11 was consistently fulfilled by all studies. In the final classification, one article achieved a moderate quality rating, three were critically low quality, and five had low quality among the nine evaluated articles. In the GRADE tool evaluation, limitations resulted in estimations for only 19 outcomes and 8 intervention-exposure sets. CONCLUSION:The results demonstrated that the writing of recent scientific articles meets most of the PRISMA 2020 criteria, with a checklist being the most used tool. Interventions and exposure were also very well reported, with the TIDieR checklist not being cited in any study as a guiding tool. AMSTAR-2 revealed a methodological approach of varied quality, mainly low and critically low. The GRADE approach classified the certainty of the evidence as generally very low. Therefore, it is necessary to encourage adherence to these approaches to improve the methodological quality in SR studies on chronic NCDs and behavioral factors in LMICs.

BACKGROUND:Climate change has severe health impacts, particularly for populations living in environmentally sensitive areas such as riversides, slopes, and forests. These challenges are exacerbated for Indigenous communities, who often face marginalisation and rely heavily on the land for their livelihoods. Despite their vulnerability, the perspectives of Indigenous populations on climate change and its impacts remain underexplored, creating a critical gap in the literature. This study explored the perceptions of Indigenous Brazilian university students on how climate change affects their daily lives and gathered their insights on potential adaptations to mitigate climate change-related impacts. METHODS:Using a participatory arts-based approach, participants captured photographs reflecting their lived experiences with climate change. Follow-up interviews provided a narrative framework for qualitative analysis, enabling participants to articulate the strengths and concerns of their communities while transcending cultural and linguistic barriers. RESULTS:The study revealed key themes, including (1) the fragility of ecosystems critical to Indigenous livelihoods, (2) the erosion of traditional knowledge systems due to environmental and social disruptions, and (3) the need for community-driven strategies to protect territories and preserve cultural identities. Participants highlighted the interconnectedness of their cultural values with environmental stewardship, emphasising the importance of maintaining these relationships as a form of resilience. CONCLUSION:This study underscores the importance of protecting Indigenous territories and respecting their cultural identities to safeguard their survival and traditions. The voices of Indigenous university students provided valuable insights into community-based adaptations and strategies for mitigating the impacts of climate change.

Objective: To evaluate the effects of a low-carbohydrate diet associated with strength training on the clinical signs of polycystic ovary syndrome (PCOS). Research Methods and Procedures: A randomized clinical trial was carried out including 29 women over 18 years old diagnosed with PCOS, randomized into two groups, with follow-up for 12 weeks: the low-carbohydrate diet group associated with strength exercise (LCDE); and the standard diet group associated with strength exercise (SDE). We evaluated manifestations of acne, hirsutism by the Ferriman-Gallwey scale and alopecia by the Ludwig-Savin scale, and assessed laboratory tests for total and free testosterone, dehydroepiandrosterone, follicle-stimulating hormone, and luteinizing hormone. The collected data were analyzed using IBM-SPSS software version 21. Results: The study showed statistically significant differences in the hormonal levels of dehydroepiandrosterone (P = 0.045), luteinizing hormone (P = 0.017) and follicle-stimulating hormone (P = 0.014) when comparing the LCDE and SDE groups. Conclusions: the intervention used can promote an improvement in the clinical presentation of PCOS, especially in hormonal parameters. The clinical trial was registered on the REBEC platform (Brazilian Registry of Clinical Trials) under number RBR4wjqxcv (Carbohydrate Reduction and Exercise in Women with PCOS) and is available on the website: https://ensaiosclinicos.gov.br/rg/RBR-4wjqxcv. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Background/Objectives: Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder frequently associated with metabolic and inflammatory disturbances. Due to its antioxidant and anti-inflammatory properties, pomegranate juice has been proposed as a potential adjunctive therapy in managing PCOS. To evaluate the effects of pomegranate juice on hormonal, inflammatory, and lipid parameters and body mass index (BMI) in women with PCOS. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted following PRISMA guidelines. Comprehensive searches were performed in electronic databases including Medline, Scopus, Web of Science, Cochrane CENTRAL, and Embase from inception to July 2025, using keywords and MeSH terms related to “polycystic ovary syndrome” and “pomegranate juice” without language restrictions. The primary outcomes were changes in serum testosterone, luteinizing hormone (LH), high-sensitivity C-reactive protein (hs-CRP), lipid profile parameters (HDL, LDL, triglycerides, and total cholesterol), and body mass index (BMI). Results: Four RCTs published between 2020 and 2023, encompassing 128 women with PCOS, were included. The meta-analysis revealed significant reductions in testosterone (MD: −0.05; 95% CI: −0.07 to −0.03; p < 0.0001; I2 = 0%, two studies, 85 participants) and hs-CRP (SMD: −0.85; 95% CI: −1.35 to −0.35; p = 0.0009; I2 = 20%, two studies, 85 participants), along with increases in HDL (MD: 6.21; 95% CI: 2.43 to 10.00; p = 0.001; I2 = 0%, two studies, 85 participants) and reductions in triglycerides (MD: −23.30; 95% CI: −45.19 to −1.42; p = 0.04; I2 = 0%, two studies, 85 participants). No significant changes were observed in LH, LDL, total cholesterol, or BMI. Conclusions: Pomegranate juice demonstrates promising effects as an adjunctive intervention in women with PCOS, improving androgen levels, inflammatory markers, and certain lipid parameters. Further long-term studies are needed to confirm these findings.

Background The WHO identifies climate change as the most significant threat to global health systems. Indigenous peoples, whose lives are deeply intertwined with nature, are particularly vulnerable to the impacts of these changes.Objective This study aimed to understand the perspectives of Indigenous stakeholders and public services managers on the interconnectedness of climate change and Indigenous health.Design A qualitative study with 22 Indigenous stakeholders and public service managers on climate change and perceived impact on Indigenous health.Setting and participants Indigenous stakeholders and public service managers on climate change and perceived impact on Indigenous health from Brazil. Data was collected through interviews incorporating two vignette videos depicting environmental and health scenarios. Thematic content analysis was used to analyse the data.Results The analytical process yielded six subcategories that were further grouped into three overarching thematic macro-categories: environmental degradation and climate change in the context of Indigenous peoples; environment, vulnerability and impact on Indigenous mental health; and actions and public health policies for Indigenous peoples.Conclusion The perspectives of Indigenous stakeholders and public service managers on the interconnectedness of climate change and Indigenous health were deeply entrenched in their lived experiences of loss of their lands from deforestation and environmental degradation. They argued strongly for the strengthening of public health policies aimed at the Indigenous peoples, to face many challenges, especially suicide, and to have a voice in decision-making. A sensitive approach that values Indigenous peoples' connections with nature is fundamental to promote their health and well-being.

OBJECTIVE:The objective of this study is to evaluate the association of disciplinary actions by regulatory councils and unprofessional behaviour during medical graduation. METHODS:A search strategy was developed using the terms: 'physicians', 'disciplinary action', 'education', 'medical', 'undergraduate' and their synonyms, subsequently applied to the electronic databases MEDLINE, Embase, Cochrane Library, LILACs and grey literature, with searches up to November 2023. The risk of bias was assessed using the Newcastle-Ottawa scale and statistical analysis was performed using the RevMan software. RESULTS:A total of 400 studies were found in the databases, and 15 studies were selected for full-texting reading. Four studies met the inclusion criteria and were included, bringing together a total of 3341 evaluated physicians. Three studies were included in the meta-analysis, showing a greater chance of disciplinary actions among physicians who exhibited unprofessional behaviour during medical graduation (OR: 2.54; 95%CI: 1.87-3.44; I2: 0%; P < 0.0001; 3077 participants; physicians with disciplinary action: 107/323; control physicians: 222/2754). CONCLUSIONS:There is a statistically significant association between unprofessional behaviour during medical undergraduate study and subsequent disciplinary actions by Medical Councils. The tools for periodic assessments of student behaviour during undergraduate studies can be a perspective for future studies aimed at reducing disciplinary actions among physicians.

Introduction:Dysbiosis characterises breast cancer through direct or indirect interference in a variety of biological pathways; therefore, specific microbial patterns and diversity may be a biomarker for the diagnosis and prognosis of breast cancer. However, there is still much to determine about the complex interplay of the gut microbiome and breast cancer.Objective:This study aims to evaluate microbial alteration in breast cancer patients compared with control subjects, to explore intestine microbial modification from a range of different breast cancer treatments, and to identify the impact of microbiome patterns on the same treatment-receiving breast cancer patients.Methods:A literature search was conducted using electronic databases such as PubMed, Embase, and the CENTRAL databases up to April 2021. The search was limited to adult women with breast cancer and the English language. The results were synthesised qualitatively and quantitatively using random-effects meta-analysis.Results:A total of 33 articles from 32 studies were included in the review, representing 19 case-control, eight cohorts, and five nonrandomised intervention researches. The gut and breast bacterial species were elevated in the cases of breast tumours, a significant increase in Methylobacterium radiotolerans (p = 0.015), in compared with healthy breast tissue. Meta-analysis of different α-diversity indexes such as Shannon index (p = 0.0005), observed species (p = 0.006), and faint's phylogenetic diversity (p < 0.00001) revealed the low intestinal microbial diversity in patients with breast cancer. The microbiota abundance pattern was identified in different sample types, detection methods, menopausal status, nationality, obesity, sleep quality, and several interventions using qualitative analysis.Conclusions:This systematic review elucidates the complex network of the microbiome, breast cancer, and therapeutic options, with the objective of providing a link for stronger research studies and towards personalised medicine to improve their quality of life.

Objective: To assess the presence of anxiety, depression and somatization in women with vulvodynia.Methods: The search for articles was performed in the electronic databases MEDLINE, via PubMed, EMBASE, LILACS and the American Psychological Association (PsycINFO). A search strategy was developed using the following terms: "Vulvodynia" and "psychological symptom" and their respective synonyms. The search was limited to human studies and no language restriction.Results: After the screening process, 10 studies met the eligibility criteria and were included in this review. The studies were published between 1993 and 2017, with 2886 participants, of which 912 are cases and 1974 are controls. Meta-analysis of included studies revealed a significant difference between groups in depression outcomes (DMP: 0.75; 95 % CI: 0.41 to 1.10; p < 0.0001; I2: 28 %), anxiety (DMP: 1.22; 95 % CI: 0.84 to 1.59; p < 0.00001; I2:0%) and somatization (DMP: 1.31; 95%CI: 0.80 to 1.82; p < 0.00001; I2: 46 %).Conclusion: Through the meta-analyses, significant associations were observed between vulvodynia and depression, anxiety and somatization.

Introduction: Type 2 diabetes mellitus (T2DM) is characterized by defects in insulin action and secretion. Bauhinia forficata has been observed to exhibit an effect in diabetes treatment due to its hypoglycemic activity. This systematic review with meta-analysis aimed to assess the effects of using Bauhinia forficata as an adjuvant treatment for individuals with T2DM. Methods: We conducted a comprehensive search strategy using relevant keywords and their synonyms, focusing on "Bauhinia forficata" and "diabetes mellitus." The search encompassed online databases such as Medline, Embase via OVID, and the Cochrane Library, without imposing language restrictions. We included studies that evaluated individuals diagnosed with T2DM, who were administered Bauhinia forficata, compared to placebo or active control, and who presented glycemia and glycated hemoglobin as outcome measures. Studies not meeting these criteria, as well as literature reviews, animal or in vitro experiments, were excluded. The methodological quality of the included studies was assessed using the Risk of Bias 2 tool. The results were presented through tables and graphs, and forest plots were generated to illustrate the effects of interventions on various outcomes, using RevMan software 5.4. Results: Four studies met the inclusion criteria, comprising two randomized controlled trials (RCT) and two nonrandomized studies of interventions (NRSI). Compared to placebo, Bauhinia forficata significantly improved glycemia (SMD -0.60, 95 % CI -0.15 to -1.05, p = 0.009, 1 RCT, n = 111, low certainty evidence; SMD -0.64, 95 % CI -1.25 to -0.03, p = 0.04, I2=42 %, 2 NSRIs pre-test/post-test, n = 40, very low certainty evidence). However, only the RCT evidence demonstrated significant improvements in HbA1c (SMD -0.48, 95 % CI -0.93, p = 0.03, 1 RCT, n = 111, low certainty evidence; SMD -0.25, 95 %CI -0.69 to 0.19, p-0.27, I2=0 %, 2 NSRIs pretest/posttest, n = 40, very low certainty evidence). No differences were found between Bauhinia forficata and Imperata brasiliensis (glycemia SMD -0.03, 95 % CI -1.01 to 0.95, p = 0.96, 1 RCT, n = 16, very low certainty evidence; HbA1c SMD 0.06, 95 % CI -0.92 to 1.04, p = 0.96, 1 RCT, n = 16, very low certainty evidence). Conclusions: The findings suggest that Bauhinia forficata may be effective in reducing blood glucose levels; however, this evidence needs to be interpreted with caution. PROSPERO registration: CRD42022370143.

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Background: Older people are the fastest-growing age group, with the highest risk of cognitive impairment. This study assessed the prevalence and associated factors with cognitive impairment in community-dwelling older people. Methods: Older people were interviewed and accomplished through sociodemographic and health questionnaires. The quantitative variables were described by mean and standard deviation or median and interquartile range. The significance level adopted was 5 % (p < 0.05). The association between the quantitative variables was evaluated using the Pearson or Spearman correlation coefficients. Results: The research population comprised 165 long-lived adults aged >= 80. The youngest one was 80, and the oldest one was 94 years old. The participants were 84.8 +/- 3.6 years old, female (63 %) with a mean of education of 2.9 +/- 1.8 years. A poor performance in the Mini-Mental State Examination (MMSE) was found in 58 (35.2 %) individuals when adjusted for educational level. After adjustment for confounding factors, body mass index (BMI) (p = 0.09), total older adults' income (up to 1 minimum wage [mw], p = 0.023; over 1 to 2 mw, p = 0.023), functional disability (Moderate dependence 75 %, p = 0.038; Moderate dependence 50 %, p = 0.081; Moderate dependence 25 %, p = 0.054), and the anxiety scale (p = 0.032), remained associated with cognitive impairment. Conclusions: This study showed that BMI, total older adults' income, functional disability, and anxiety are related to cognitive impairment in long-lived adults. This study has some limitations, such as the fact that it is a cross-sectional study, the reduced number of individuals, and the fact that there were no comparisons among different ages and populations.

Cervical cancer is the third most common gynecological cancer worldwide. Its origin is linked to intraepithelial lesions caused by high-risk Human Papillomavirus (HPV) types, detected in 99.7% of cases. Early screening is essential to prevent cancer development from these lesions. Molecular methods are more specific and offer the possibility of being performed through a self-collected sample by the patient, thus contributing to increasing screening coverage for this pathology. This study aim was to map the medical-scientific literature on existing protocols for self-sampling for HPV testing in cervical cancer screening. A search strategy was developed using the following keywords and their synonyms: "self-sampling," "professional sampling," and "HPV", on the databases: MEDLINE, Cochrane Library, Virtual Health Library - BVS, Scopus, National Institute for Health Research NHS EED, Web of Science, and EMBASE. The search strategy was formulated to identify relevant studies and describe their main characteristics, such as patient acceptance of self-sampling, cost differences between the tests used, and the accuracy of self-sampling compared to the gold standard test. A total of 876 studies were found, and 33 of those studies were included in this review. Out of these, 10 studies were domized clinical trials involving 46,751 patients, and 23 observational studies included 142,795 patients. Regarding acceptance, most studies reported a preference for self-sampling. Sensitivity analyses from various studies also showed that the low cost of self-sampling kits generally increased cost-effectiveness. The study concluded that using HPV testing on self-collected samples is a viable strategy for monitoring women with HPV.

AIMS:Postmenopausal women experience an increase in cardiovascular, sexual, and emotional changes that can significantly impact their quality of life. Although phytoestrogens offer therapeutic benefits, our understanding of resveratrol's effects remains limited. This study aims to evaluate the effects of using resveratrol on the lipid profile of postmenopausal women. DATA SYNTHESIS:We conducted a systematic review using search terms like "postmenopausal" and "resveratrol" and their synonyms. Two reviewers handled study selection and data extraction. Randomized clinical trials assessing resveratrol in post-menopausal women were included. The meta-analysis on total cholesterol levels found no significant difference between groups, Standardized Mean Difference (SMD) -0.09 (95 % Confidence Interval (CI) -0.39 to 0.22, p = 0.59; I2 = 0 %, 2 studies, low-quality evidence). No significant differences were found in high-density lipoprotein (HDL) levels, SMD 0.00 (95 % CI -0.31 to 0.31, p = 1; I2 = 0 %, 2 studies, low-quality evidence), Low-Density Lipoprotein (LCD) levels, SMD -0.10 (95 % CI -0.40 to 0.21, p = 0.54; I2 = 0 %, 2 studies, low-quality evidence), and triglyceride levels, SMD -0.12 (95 % CI -0.18 to 0.43, p = 0.43; I2 = 0 %, 2 studies, low-quality evidence). CONCLUSION:This review concludes there's limited evidence for recommendations; further studies with higher doses, longer supplementation durations, and exploration of outcomes are needed to clarify therapeutic potential.

Introduction Fibromyalgia syndrome (FMS) is a chronic condition that associates pain, sleep disturbances, and cognitive changes. Recent evidence shows that sexual dysfunction is also associated with fibromyalgia, further affecting patients’ quality of life. Objective Our aim was to explore the association between FMS and sexual dysfunction (SD) in women. Methods A comprehensive search strategy was carried out, using the keywords “fibromyalgia” and “sexual dysfunction” and their synonyms. The databases used were MEDLINE, EMBASE, Scopus, Biomed Central, Web of Science, CINAHL, IBECS, LILACS, Congress Abstracts, and gray literature sources like Google Scholar. Studies published from January 1990 to August 2023 were considered, without imposing any language restrictions. The inclusion criteria involved studies that investigated individuals diagnosed with FMS and who suffered from sexual dysfunction, while studies that did not meet these criteria were excluded. The methodological quality of the included studies was assessed using the New Castle Ottawa tool. The results were presented in tables and forest graphs generated by the RevMan 5.4 software. Results 27 studies were included, 10 of which were case-control and 17 were cross-sectional. These studies were published between 2005 and 2023, with participants aged between 18 and 81 years. Patients with FMS performed markedly worse than healthy controls in all domains of sexual dysfunction assessed. The methodological quality of the included studies was classified as moderate to high. Conclusion Compared to healthy women, the findings indicate a negative correlation between sexual dysfunction and fibromyalgia. These results underscore the significance of addressing sexual disturbances as a source of distress in the context of fibromyalgia syndrome. It becomes evident that incorporating psychological therapies that encompass emotional, physical, and sexual health could be a pivotal component in the comprehensive treatment of fibromyalgia syndrome.