Antonio José Grande

Non-Puerperal Uterine Inversion: A Systematic Review

Background: Non-puerperal uterine inversions are rare. The objective of the study was to investigate the frequency, causes, clinical presentations, and management of published case reports of non-puerperal uterine inversion. Material and Methods: We searched MEDLINE, EMBASE, LILACS, the Cochrane Central Register of Controlled Trials, IBECS, BIOSIS, the Web of Science, SCOPUS, Conference Abstracts, and grey literature (Google scholar; the British Library) for papers published from January 1940 through March 2017. Results: We found a total of 170 case reports. The most common cause was leyomioma (57.2%) followed by sarcoma (13.5%). The definitive treatment of most cases was hysterectomy (86.8%). The median hemoglobin levels were seven, showing the severity of the condition by previous vaginal bleeding. All reported cases had a correct management demonstrated by the prognosis until hospital discharge. All patients were discharged, most of them without serious postoperative events. Cancer cases were referred for proper treatment. Only 2 cases of death were reported in 6 weeks and 3 months, respectively, both cases of cancer in advanced stages. Conclusion: Non-puerperal uterine inversion is rare. There have been 170 cases reports in the literature since 1940.

Accuracy of immunoglobulin M and immunoglobulin A of saliva in early diagnosis of dengue: Systematic Review and Meta-analysis

The objective of the study was to conduct a systematic review to synthesize the current evidence on the accuracy of IgM and IgA to early diagnosis the dengue virus. The review protocol was registered at PROSPERO (CRD 42015024808). We searched for studies in the following electronic database from 1990 to January 2018. The search identified 3507 studies. Five studies were included for quantitative analysis. Three studies included evaluations of salivary IgM provided a sensitivity of 86% and specificity of 93%. Two studies included evaluating of IgA salivary showed a combined sensitivity of 69% and a combined specificity of 98%. Despite the results found and the low methodological quality of the studies included in the meta-analysis it is still soon to claim that IgA is better than IgM to diagnosis Dengue.