Fábio Rosa Silva

Prevalence of human papillomavirus in breast cancer: a systematic review.

Objective We performed a systematic review and meta-analyses to estimate the prevalence of human papillomavirus (HPV) in breast carcinoma and to explore the reasons for the ongoing controversies about this issue. Materials and Methods A comprehensive search of the Cochrane Library, MEDLINE, CANCERLIT, LILACS, and EMBASE databases was performed for papers published from January 1990 to January 2011. The medical subject heading terms were searched for the following: breast neoplasm, breast lesions, breast cancer, and HPV or human papillomavirus. Statistical analysis was performed using REVMAN 5.0. Results Twenty-nine primary studies, including 2211 samples, were analyzed. Overall, HPV prevalence in patients with breast cancer was 23.0% (95% CI, 21.2%–24.8%). The prevalence of HPV ranged from 13.4% (95% CI, 10.2%–16%) in Europe to 42.9% (95% CI, 36.4%–49.4%) in North America and Australia. The prevalence of HPV in controls was 12.9%. Combinations of 9 case-control studies showed that breast cancer was associated with HPV (odds ratio, 5.9; 95% CI, 3.26–10.67). Conclusion We found a high prevalence of HPV DNA in breast cancer. There is strong evidence to suggest that HPV has an important role in the development of breast cancer.

Human papillomavirus and cervical neoplasia.

Human papillomavirus (HPV) has been established as an important etiological factor for the development of cervical cancer. This DNA virus primarily infects the epithelium and can induce benign and malignant lesions of the mucous membranes and skin. Some HPVs are considered high risk due to their role in malignant progression of cervical tumors. Genital HPV infections are common and usually transient among young sexually active women. Only a small fraction of infected women develop cervical cancer, implying the involvement of environmental and genetic cofactors in cervical carcinogenesis. Classification, virology, pathology, natural history, epidemiological features of genital HPV infection, and future prospects for cervical cancer prevention with HPV vaccines will be reviewed here.

Accuracy of magnetic resonance imaging in ovarian tumor: a systematic quantitative review

OBJECTIVE To estimate the diagnostic accuracy of magnetic resonance in ovarian tumors. STUDY DESIGN A quantitative systematic review was performed. Studies that compared magnetic resonance and paraffin sections within subjects for diagnosis of ovarian tumors were included. RESULTS Fifteen primary studies were analyzed, which included 1267 ovarian masses. For borderline or malignant ovarian cancer vs benign ovarian lesions, the pooled likelihood ratio for the occurrence of a positive magnetic resonance result was 6.6 (95% confidence interval, 4.7-9.2) and the posttest probability for borderline or malignant diagnosis was 77% (95% confidence interval, 70-82). Because specificity and likelihood ratio positive were heterogeneous, a random effect model was used and a summary receiver operating characteristic curve was generated. For borderline or malignant ovarian cancer vs benign ovarian lesions, the area under curve was 0.9526. CONCLUSION Magnetic resonance seems to be a useful preoperative test for predicting the diagnosis of pelvic masses.

Weekly fluconazole therapy for recurrent vulvovaginal candidiasis: a systematic review and meta-analysis.

OBJECTIVE To investigate the efficacy, compared to placebo, of fluconazole 150 mg weekly, given for six months as prophylaxis against recurrent vulvovaginal candidiasis (RVVC). STUDY DESIGN A quantitative systematic review was performed, and randomized controlled trials were included. We conducted searches at Medline, EMBASE, Lilacs, Cochrane Library and ICI Web of Science from 1980 to March 2012. We used the odds ratio (OR) with confidence intervals (CI) of 95% using a random effects model of Mantel-Haenszel. The software used was Review Manager version 5.0. RESULTS Through the search strategies we identified 249 articles, of which only two were part of the meta-analysis. Fluconazole was more effective than placebo in reducing symptomatic episodes of VVC, immediately after treatment (OR 0.10, 95% CI 0.03-0.34), 3 months after treatment (OR 0.23, 95% CI 0.07-0.74) and 6 months after treatment (OR 0.39, 95% CI 0.24-0.64). CONCLUSION Weekly treatment with fluconazole (150 mg) for six months is effective against RVVC.

Approaching the matched filter bound with block transmission techniques

Block transmission techniques, with appropriate cyclic prefixes and employing frequency-domain equalisation techniques, have been shown to be suitable for high data rate transmission over severely time-dispersive channels. The most popular techniques based on this concept are orthogonal frequency division multiplexing (OFDM) and single-carrier with frequency-domain equalisation (SC-FDE). In this paper, we consider OFDM and SC-FDE transmission schemes and study the impact of the number of multipath components and the diversity order on their performance. It is shown that when we have a high number of separable multipath components, the asymptotic performance of both schemes approaches the matched filter bound, even without diversity. When we have diversity, the performance approaches the matched filter bound faster, with a small number of separable multipath components. It was also observed that the SC-FDE has an overall performance advantage over the OFDM option, especially when employing the iterative block decision feedback equaliser with turbo equalisation and for high code rates. Copyright

Accuracy of telomerase in estimating breast cancer risk: A systematic review and meta-analysis

OBJECTIVE To determine the accuracy of telomerase activity in predicting a higher risk for breast cancer. STUDY DESIGN A quantitative systematic review was performed. Studies that detected telomerase activities in breast tissue were included. RESULTS Twenty-five primary studies were analyzed, which included 2395 breast lesions. The proportion of breast cancer was 60.8%. Eighty-two percent (1193/1455) of breast cancer cases and 18% (169/940) of benign lesions cases were positive for telomerase activity. For breast cancer vs benign or normal breast tissue, the pooled likelihood ratio for the presence of telomerase activity was 4.5 (95% confidence interval [CI], 3.1-6.5) and the post-test probability was 88% (95% CI, 83-91). For breast cancer vs benign or normal tissue, the area under the summary receiver operating characteristic (SROC) curve was 0.89 with the Q* point value of 0.82. CONCLUSION Our systematic review showed that telomerase activity was significantly present in breast cancer when compared with normal breast tissue or benign breast lesions.

Laparoscopic Approach of a Unicornuate Uterus with Noncommunicating Rudimentary Horns

Background. Müllerian duct malformations delineate a miscellaneous group of congenital anomalies that result from arrested development, abnormal formation, or incomplete fusion of the mesonephric ducts. Case. This paper describes the diagnosis and management of a noncommunicating rudimentary horn complicated by severe pelvic pain and associated endometriosis. Conclusion. This condition was diagnosed by laparoscopy and hysteroscopy examination. Operative videolaparoscopy proved to be a successful approach for the treatment of this congenital Müllerian anomaly.

A randomized clinical trial on the effects of remote intercessory prayer in the adverse outcomes of pregnancies

The scope of this article was to investigate whether intercessory prayer (IP) influences the adverse outcomes of pregnancies. A double-blind, randomized clinical trial was conducted with 564 pregnant women attending a prenatal public health care service. The women were randomly assigned to an IP group or to a control group (n = 289 per group). They were simultaneously and randomly assigned to practice prayer off-site or not. The following parameters were evaluated: Apgar scores, type of delivery and birth weight. The mean age of the women was 25.1 years of age (± 7.4), and the average gestational age was 23.4 weeks (± 8.1). The average number of years of schooling for the women was 8.1 years (± 3.1). The women in the IP and control groups presented a similar number of adverse medical events with non-significant p. No significant differences were detected in the frequency of adverse outcomes in pregnant women who practiced IP and those in the control group.

Channel Estimation and Equalization for Asynchronous Single Frequency Networks

Single carrier frequency-domain equalization (SC-FDE) modulations are known to be suitable for broadband wireless communications due to their robustness against severe time-dispersion effects and the relatively low envelope fluctuations of the transmitted signals. In this paper, we consider the use of SC-FDE schemes in broadcasting systems. A single frequency network transmission is assumed, and we study the impact of distinct carrier frequency offset (CFO) between the local oscillator at each transmitter and the local oscillator at the receiver. We propose an efficient method for estimating the channel frequency response and CFO associated to each transmitter and propose receiver structures able to compensate the equivalent channel variations due to different CFO for different transmitters. Our performance results show that we can have excellent performance, even when transmitters have substantially different frequency offsets.

Hyperbilirubinaemia alone cannot distinguish a perforation in acute appendicitis

The objective of the study was to verify the accuracy of hyperbilirubinaemia as a marker for acute perforated appendicitis.